Isolated paraglottic abscess: a case report

A 60-year-old gentleman presented with dyspnoea, hoarse voice and stridor. He had no history suggestive of airway instrumentation or prior laryngeal pathology. Bedside flexible nasopharyngo-laryngoscope revealed grossly oedematous bilateral false vocal cord. Computerized tomography scan of the neck with contrast showed rim-enhancing lesions at the paraglottic space and bilateral false vocal cord. A presumptive diagnosis of isolated paraglottic abscess was made. Patient was subjected to tracheostomy, then endoscopic assessment of the larynx. Pus was drained and parenteral antibiotics were commenced. Further assessment revealed improving false vocal cords oedema but right vocal cord palsy was documented. Patient was subsequently discharged well and tracheostomy was successfully decannulated once vocal cords and voice returned to normal. Although occurrence of isolated abscess in the paraglottic region is rare, this disease entity should be considered as a differential diagnosis in the presentation of upper airway obstruction with no prior laryngeal pathology or airway instrumentation.